Retroperitoneal extraskeletal osteosarcoma

Extraskeletal osteosarcomas are rare malignant mesenchymal neoplasms characterised by the direct production of osteoid or bone by tumour cells. By definition, they are located in the soft tissues without primary bone or periosteal involvement. The most common location of these tumours is the lower extremity, especially the thigh, followed by the upper extremity and the retroperitoneum.1–4 We report the radiological presentation of a retroperitoneal extraskeletal osteosarcoma, which may be helpful in the consideration of its differential diagnosis. A 68 year old man presented with a painless palpable mass in the right side of the abdomen. A previous trauma was denied. The patient was not on anticoagulant medication. Except for a cholecystectomy in 1986, his medical history was unremarkable. Physical examination revealed a firm mass measuring approximately 10 × 10 cm. Laboratory findings were within normal limits, with the exception of a slightly raised alkaline phosphatase concentration of 140 U/litre (normal range, 40–120). Plain radiography of the abdomen demonstrated a large ill defined dense lesion projecting over the right side of the pelvis. Contrast enhanced helical computed tomography (CT) of the abdomen identified a large, non-homogeneous soft tissue mass in the right side of the retroperitoneum (fig 1). The tumour measured 9 × 12 × 14 cm. The medial part of the mass was …